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Is HIV/Sexually Transmitted Disease Prevention Counseling Effective Among Vulnerable Populations?: A Subset Analysis of Data Collected for a Randomized, Controlled Trial Evaluating Counseling Efficacy (Project RESPECT)

Bolu, Omotayo O. MBBS, MSc*; Lindsey, Catherine MPH*; Kamb, Mary L. MD, MPH*; Kent, Charlotte MPH; Zenilman, Jonathan MD; Douglas, John M. Jr MD§; Malotte, C Kevin DrPH; Rogers, Judy MS; Peterman, Thomas A. MD, MSc*the Project RESPECT Study Group

Sexually Transmitted Diseases: August 2004 - Volume 31 - Issue 8 - p 469-474
doi: 10.1097/01.olq.0000135987.12346.f2

Objective: The objective of this study was to evaluate counseling efficacy among high-risk groups.

Study: We conducted a subset analysis of data collected from July 1993 through September 1996 during a randomized, controlled trial (Project RESPECT). Participants (n = 4328) from 5 public U.S. sexually transmitted disease (STD) clinics were assigned to enhanced counseling, brief counseling, or educational messages. For 9 subgroups (sex, age, city, education, prior HIV test, STD at enrollment, race/ethnicity, injection drug use, exchanging sex for money/drugs), we compared STD outcomes for those assigned either type of counseling with STD outcomes for those assigned educational messages.

Results: After 12 months, all subgroups assigned counseling (brief or enhanced) had fewer STDs than those assigned educational messages. STD incidence was similar for most subgroups assigned enhanced or brief counseling. All subgroups had an appreciable number of STDs prevented per 100 persons counseled, especially adolescents (9.4 per 100) and persons with STD at enrollment (8.4 per 100).

Conclusions: HIV/STD prevention counseling (brief or enhanced counseling) resulted in fewer STDs than educational messages for all subgroups of STD clinic clients, including high-risk groups such as adolescents and persons with STDs at enrollment.

A subset analysis of data from a randomized, controlled trial evaluating counseling efficacy (Project RESPECT) found counseling resulted in fewer sexually transmitted diseases (STDs) among several vulnerable populations, including adolescents and persons with STD at enrollment.

From the *Division of HIV/AIDS Prevention-Surveillance and Epidemiology, National Center for HIV, STD & TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; †San Francisco Health Department, San Francisco, California; ‡Baltimore City Health Department and Johns Hopkins University, Baltimore, Maryland; §Denver Public Health and Colorado Department of Health and Environment, Denver, Colorado; ∥Long Beach Health Department and California State University, Long Beach, California; and the ¶New Jersey Health Department, Trenton, and Newark STD Clinic, Newark, New Jersey

Presented in part at the National HIV Prevention Conference, August 2001 (Abstract # 545), Atlanta GA; and the American Public Health Association (APHA) Annual Meeting, Atlanta, GA, October 2001 (Abstract # 5035).

Informed consent was obtained from all clients participating in the study. Human experimentation guidelines of the US Department of Health and Human Services and those of participating institutions were followed in the conduct of this research.

Correspondence: Omotayo O. Bolu, MBBS, MSc, Global AIDS Program, National Center for HIV/STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE, Mail Stop E-04, Atlanta, GA 30333. E-mail:

Received for publication December 17, 2003, and accepted March 24, 2004.

© Copyright 2004 American Sexually Transmitted Diseases Association